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Heart Surgery at
Heart Care Centers of
Illinois |
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Contents: |
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Why
Heart Surgery? |
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Structure
and Function of the Heart:
The heart
is a four-chambered, hollow, muscular organ. It is located within the chest, behind
the breast bone (sternum) and slightly to the left. It is the size of one's fist,
and it weighs less than one pound. The heart's job is to pump blood to every part of
the body. The AORTA and ARTERIES
carry oxygen and nutrient-enriched blood away from the heart to all the cells of the
body. The VEINS then collect the blood from these cells and carry it back to the
right side of the heart.
The two upper chambers of the heart are called the right and left ATRIA . The right atrium receives
the venous blood from the body. The left atrium receives the blood from the
lungs. The two lower chambers are called the VENTRICLES . These muscular
chambers pump blood out of the heart. The right ventricle pumps venous blood only to
the lungs. In the lungs, the red blood cells pick up oxygen, and the oxygenated
blood is pumped to the remainder of the body by the left ventricle.
There are four VALVES
present within the heart. These valves act as one-way doors to prevent the back-flow
of blood. A wall called the SEPTUM
divides the heart into right and left sides.
The heart is the hardest working muscle in the body. For this reason, it
requires a continuous supply of oxygen and nutrient-enriched blood. The heart muscle
receives its blood supply from the CORONARY ARTERIES. There are three
primary coronary arteries, and each one has many smaller branches, allowing every portion
of the heart to receive blood. The right and left main coronary arteries originate
from the aorta.
The three primary arteries include:
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Right Coronary Artery-
supplies blood to the right half of the heart.
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Left
Anterior Descending Artery- supplies blood to the front portion of the heart muscle.
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Left
Circumflex (LCx) Coronary Artery- supplies blood to the
left side and back of the heart.
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Coronary Arteries and Great Vessels
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Right Coronary
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Left Anterior Descending
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Left Circumflex
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Superior Vena Cava
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Inferior Vena Cava
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Aorta
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Pulmonary Artery
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Pulmonary Vein
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Coronary
Artery Disease:
Blockages can occur
in the coronary arteries, decreasing the amount of blood flow to the heart muscle.
The most common cause of blockages is fatty deposits (atherosclerosis) accumulating in the
walls of the coronary arteries. This accumulation of fatty deposits is thought to be
influenced by numerous risk factors that include:
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As deposits continue to build within the arterial wall, the internal diameter of the
vessel decreases, blockage results, and the blood supply to the heart muscle is
jeopardized. This often results in chest pain known as ANGINA. Anginal pain is
usually relieved by nitroglycerine and rest.
If
blood flow through a coronary artery becomes severely reduced, a portion of the heart
muscle becomes damaged and may die-- known as a Myocardial Infarction (MI) or heart
attack. MI's are felt to be a consequence of blood clot
formation (plaque rupture and thrombosis) in a coronary artery.
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Coronary
Angiogram:
The Coronary Angiogram is the
cornerstone of a left heart catheterization (or cardiac "cath"). This test
is used to determine the location and severity of any blockages present in the heart's
arteries, and assesses the function of the heart valves. During the test, a small
amount of dye is injected into the coronary arteries, and is recorded digitally using
X-ray imaging. Dye is also injected into the left ventricle of the heart to
establish whether any damage has occurred to this muscle or to the heart valves.
The cardiologists and cardiovascular surgeons will look at
the results of the cardiac catheterization films and decide if open heart surgery is
needed or if an alternative method of treatment can be used. Alternative methods of
therapy include coronary angioplasty (PTCA), rotational
atherectomy, and coronary stenting. The recommended treatment will depend upon your
personal medical history, the anatomy of coronary artery disease that is
present, and your individual needs.
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Coronary
Artery Bypass Surgery:
Coronary
artery bypass surgery restores blood supply to various areas of the heart muscle.
This is done by attaching one end of a saphenous vein segment (which is removed from the
leg) to the aorta, and the other end of the vein just beyond the point of blockage in the
coronary artery. The blocked portion is not removed. This vein graft will now
deliver an increased blood supply to the heart muscle that lies beyond the point of
blockage. The internal mammary artery, which courses inside
the chest wall, is also used as a bypass graft conduit. |
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Cardiac Chamber and Valves
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Right Atrium
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Right Ventricle
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Left Atrium
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Left Ventricle
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Papillary Muscles
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Chordae Tendineae
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Tricuspid Valve
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Mitral Valve
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Pulmonary Valve
Aortic Valve (Not pictured)
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Heart
Valve Replacement Information: |
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The heart has four Valves:
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Aortic
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Mitral
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Tricuspid and Pulmonic
These one-way valves separate the heart chambers from
one-another and from the "great vessels" and keep blood flowing properly.
Diseases such as rheumatic fever, infection, atherosclerosis, or birth defects may cause
the valves to leak or become obstructed. Depending on the extent of valve damage,
surgery may be advised to either repair or replace the valve. |
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Bioprosthetic (tissue) Valve |
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Prosthetic, or replacement,
valves come in two flavors, mechanical (metal) and bioprosthetic (from living tissue). The
mechanical valves are especially durable and require long-term therapy with blood thinners
(anticoagulants).
The tissue valves are not quite as durable as their mechanical counterparts, but
typically don't require blood-thinning. The decision on what type of valve to
implant is arrived at jointly by considering your needs and the recommendations of your
cardiologist and cardiovascular surgeon.
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St. Jude Mechanical Valve |
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Learn What
to Expect During and After Heart Surgery |
